Provider Demographics
NPI:1639588601
Name:LEACH, JAMES FRANKLIN (APRN)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:FRANKLIN
Last Name:LEACH
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5637
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75505-5637
Mailing Address - Country:US
Mailing Address - Phone:903-831-7270
Mailing Address - Fax:903-794-0496
Practice Address - Street 1:125 ARKANSAS BLVD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:AR
Practice Address - Zip Code:71854-1963
Practice Address - Country:US
Practice Address - Phone:870-772-9355
Practice Address - Fax:870-772-9360
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004170363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily